29th April 2024

A 45-year-old woman presents with a 2-month history of progressive swelling around her ankles and eyelids.

A 45-year-old woman presents with a 2-month history of progressive swelling around her ankles and eyelids. She also mentions feeling increasingly fatigued and reports foamy urine. She has no significant past medical history and takes no regular medications. On examination, her blood pressure is 130/80 mmHg. Laboratory investigations reveal:

Serum albumin: 25 g/L (35–50)

Serum creatinine: 88 µmol/L (45–90)

Urine protein: 4+ (on dipstick)

Serum cholesterol: 7.8 mmol/L (3.6–5.2)

Urine microscopy: no cells or casts

Which is the most likely diagnosis?